Outcome of Uncemented Unipolar Hemiarthroplasty in Fracture Neck of Femur, in Geriatric Patients in Relation to Bone Quality

Abstract

BACKGROUND: Osteoporosis plays an important role in pathogenesis of fracture neck of femur in mobile elderly. Hemiarthroplasty is most common mode of management of femoral neck fractures in elderly in developing world. We report the outcome of uncemented hemiarthroplasty in elderly patients with a femoral neck fracture in relation to bone quality of patient as estimated by Dual energy x ray absorptiometry (DEXA scan). MATERIALS AND METHODS: 75 uncemented hemiarthroplasties for femoral neck fractures were performed in elderly patients more than 70 years of age between August 2008 and April 2012. The clinical, radiological results and bone mineral density of 65 hips in 65 patients who could be followed up were analyzed. For all cases Austin Moore prosthesis was implanted. RESULTS: The mean age of the patients was 79.96±7.21 years (71 to 96 years). 44 patients were women and 21 were men. Average duration of follow-up was 18.59±11.53 months (Range 4 to 44 months). The mean Harris Hip Score in patients with osteopenia was 80.29±13.29 and in patients with osteoporosis it was 79.96 ± 11.67 at the time of the last follow-up. There was no significant difference in mean Harris hip score in osteoporotic and non-osteoporotic patient's p value 0.923. Out of 65 patients whose results were assessed in our study 48 patients (73.8%) had osteoporosis and 17 patients (26.1%) had Osteopenia. None of the patients in our study had a normal bone density. The mean T Score as measured on DEXA scan was-3.74±1.57. CONCLUSION: Uncemented hemiarthroplasty for elderly patients more than 70 years of age with a femoral neck fracture showed satisfactory short-term results with no relationship to the bone quality.